Guidelines for Tracking Interventional Radiology Patient Care and Procedural Experiences Review Committee for Radiology

Transcription

1 Guidelines for Tracking Interventional Radiology Patient Care and Procedural Experiences Review Committee for Radiology To comply with the Program Requirements for Graduate Medical Education in Interventional Radiology, the procedural training experience of each interventional radiology resident must be tracked through two methods: 1. ACGME Resident Case Log System 2. Interventional Radiology Patient Procedural Encounters Log Resident Case Log System The ACGME s Resident Case Log System is intended to capture a sample of the procedural experiences of an interventional radiology resident. Interventional radiology case data must be entered into the Case Log System for each resident. Interventional radiology Case Log data are entered in aggregate, similar to the diagnostic radiology Case Logs, and must be reviewed at least semiannually by the program director for accuracy [Program Requirement II.A.4.r)]. Specific interventional radiology Case Log procedural categories were chosen to provide a representative picture of resident procedural activities across the full domain of interventional radiology (see Table 1). Procedural minimums have not been established at this time, but will be determined in the future once sufficient data has been collected. Of note, initial interventional outpatient evaluation, while not a procedure, is an important resident experience and has been included as a Case Log category. Interventional radiology-integrated program directors must track both interventional radiology Case Log categories and diagnostic radiology Case Log categories (see Table 2). Interventional radiology-independent program directors need to track only the interventional radiology Case Log categories. Interventional radiology Case Log categories are defined by CPT codes, shown in Table 3. The Association of Program Directors in Interventional Radiology/Society of Interventional Radiology will inform the ACGME of CPT code updates on an annual basis. Interventional Radiology Patient Procedural Encounters Log An interventional radiology patient procedural encounter is defined as a patient visit during which an interventional radiology patient is evaluated or treated by a resident. This includes visits in which an interventional radiology patient undergoes an interventional radiology or interventional radiology-related procedure, as well as outpatient visits in which an initial evaluation is performed. The Interventional Radiology Patient Procedural Encounters Log reflects the cumulative procedural experience of an interventional radiology resident. The Program Requirements for Graduate Medical Education in Interventional Radiology specify a minimum number of procedures per resident (1000 procedures during the interventional radiology residency, and

2 500 during the Early Specialization in Interventional Radiology (ESIR) curriculum). Programs must ensure that residents keep a log of all interventional radiology patient procedural encounters in order to track the cumulative procedural experience obtained during training. The cumulative Interventional Radiology Patient Procedural Encounters Log, commonly known as a procedure log, should track the volume and type of all procedures and patient encounters, but should also provide some meaningful detail about each case. Guidelines for Determining Interventional Radiology Case Log Numbers 1. Case Log entries are defined and counted according to established CPT code descriptions of interventional radiology procedural activity (Table 3). 2. The Case Log information for each ESIR resident who enters an independent program must be entered into the Resident Case Log System by the receiving interventional radiology-independent program director upon resident matriculation. 3. No more than two residents can take credit for the same procedure. Guidelines for Counting Patient Encounters 1. An interventional radiology patient encounter is associated with an interventional radiology or interventional radiology-related procedure or initial outpatient evaluation and management visit. 2. Vascular imaging studies do not count toward interventional radiology patient encounters. 3. A resident must be the first operator on a patient procedural encounter in order to count it. An exception can be made to allow both a senior and a junior resident to count the same procedure when the senior resident is supervising the performance of a minor procedure performed by the junior resident. Considerations for ESIR 1. Upon completion of ESIR training, the diagnostic radiology program director must provide residents with written verification of their completion of a minimum of 500 patient procedural encounters. This written verification, along with the resident s procedure log, must be provided to the interventional radiology-independent program director upon the resident s matriculation into the program. Please see Appendix 1 for a sample of a standardized form to be used. 2. Residents who successfully complete ESIR training and enter an interventional radiology-independent program in the second year of training should include in their logs all interventional radiology patient procedural encounters completed during the ESIR curriculum in addition to those completed during the interventional radiologyindependent program.

3 Table 1: Interventional Radiology Case Log Categories Dialysis Access Intervention Embolization Primary GI Intervention (P, Cholecystostomy, Gastrostomy) Primary Nephrostomy Thrombolysis or Thrombectomy (Arterial or Venous) TIPS or TIPS Revision Venous Port Venous Intervention (Stent, PTA, or filter) REQUIRED MINIMUM Table 2: Diagnostic Radiology Case Log Categories CASE LOG CATEGORY (11) REQUIRED MINIMUM Chest X-Ray 1900 CTA/MRA 100 Mammography 300 CT Abdominal/Pelvic 600 US Abdominal/Pelvic 350 Image Guided Biopsy/Drainage 25 MRI Lower Extremity Joints 20 MRI Brain 110 PET 30 MRI Body 20 MRI Spine 60

4 Table 3: Interventional Radiology CPT Codes by Category CPT CODES 33880, 33881, 34701, 34702, 34703, 34704, 34705, 34706, 34707, 34708, 34713, 34841, 34842, 34843, 34844, 34845, 34846, 34847, 34848, 37220, 37221, 37224, 37225, 37226, 37227, 37228, 37229, 37230, 37231, 37236, Dialysis Access Intervention 36901, 36902, 36903, 36904, 36905, Embolization 37241, 37242, 37243, 37244, , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, Primary GI Intervention (P, 47533, 47534, 47490, Cholecystostomy, Gastrostomy) Primary Nephrostomy 50432, Thrombolysis or Thrombectomy (Arterial or 37184, 37187, 37211, Venous) TIPS or TIPS Revision 37182, , 20983, 32994, 32998, 47382, 47383, 50592, Venous Port 36560, Venous Intervention (Stent, PTA, or filter) 37191, 37193, 37238, 37248

5 Appendix 1: Standardized Form for ESIR Resident Training Verification Verification of ESIR Training Programs should complete this form and provide to the accepting interventional radiologyindependent program director for each resident who completes ESIR training. Resident Name: The above-named resident has successfully completed our ACGME-approved ESIR curriculum. This form summarizes the procedural experience obtained during the ESIR training and includes interventional radiology Case Log volumes and the total number of interventional radiology patient procedural encounters. ACGME Case Logs Dialysis Access Intervention Embolization Primary GI Intervention (P, Cholecystostomy, Gastrostomy) Primary Nephrostomy Thrombolysis or Thrombectomy (Arterial or Venous) TIPS or TIPS Revision Venous Port Venous Intervention (Stent, PTA, or filter) Number Performed Interventional Radiology Patient Procedural Encounters The total number of interventional radiology patient procedural encounters in which the resident participated during ESIR training is. A detailed log enumerating these patient procedural encounters has been reviewed by myself, with the resident, and a copy is attached to this form. Diagnostic Radiology Program Director Name: Date: